Utilization Management Pharmacist Trainer

Position Summary:
We are seeking a dynamic and experienced pharmacist trainer to join our team. As a pharmacist Trainer, you will play a pivotal role in developing and delivering training programs that enhance knowledge, operational efficiency, and customer service skills to our pharmacist staff. The successful candidate will have a strong background in pharmacy practice, a passion for education and the ability to create engaging and impactful training content. 

Position Responsibilities:

•    Facilitate the onboarding process for new hires and provide comprehensive training sessions for pharmacists on prior authorization systems, processes, and procedures utilizing a variety of training methods. 
•    Develop and update training materials, resources, verbiage templates, job aids, and communicate updates to the team. 
•    Ensure that training content is accurate, up-to-date, clinically relevant, compliant with federal and state regulations, and internal policies. 
•    Maintain detailed records of training sessions, participant attendance, and training materials for auditing and reporting purposes. 
•    Assess performance of pharmacists through evaluations, quizzes, and practical assessment to identify areas for improvement and provide constructive feedback. 
•    Collaborate with pharmacy managers, supervisors, and other relevant stakeholders to identify training needs, performance gaps and ensure alignment with company goals. 
•    Make clinical prior authorization and appeals determinations in accordance with medical necessity and covered benefit guidelines within established turnaround times. 
•    Provide detailed and thorough documentation in prior authorization cases, overrides and call center cases. 
•    Perform peer-to-peer reviews with providers when requested. 
•    Perform scientific literature evaluation using primary, secondary, and tertiary drug resources to support decision-making and recommendations to providers. 
•    Effectively communicate issues and resolutions to members, pharmacies, providers, and appropriate internal stakeholders. 
•    Provide backup support to call center team as required.

Required Qualifications:

•    A Doctor of Pharmacy (Pharm.D.) degree or Bachelor of Pharmacy degree from an accredited pharmacy program.  
•    An active unrestrictive pharmacist license. 
•    3+ years of experience as a clinical pharmacist in Pharmacy Benefit Management (PBM) setting. 
•    Previous experience developing and delivering training programs. 
•    Solid understanding of prior authorization operations, Federal and State laws, and regulations. 
•    Excellent written communication and presentation skills to effectively convey complex information to diverse audiences. 
•    Excellent analytical skills and attention to detail. 
•    Ability to collaborate effectively with cross-functional teams and adapt to changing priorities. 
•    Proficiency in using e-learning platforms, multimedia tools, and Microsoft Office Suite. 
•    Ability to work a flexible schedule independently with minimal supervision, staying productive in a remote, high-volume, and metric driven call center environment.

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.